Traumatic aortic rupture requires rapid, definitive repair for optimal outcome, particularly with respect to distal neurologic function. Over the past 10 years, the R Adams Cowley Shock Trauma Center of the University of Maryland has used partial cardiopulmonary bypass without systemic heparization exclusively for all repairs of the descending aorta. A heparin-bonded circuit allows for controlled distal perfusion and obviates the need for heparinization. Excellent outcome with minimal morbidity has been achieved using this technique. Our protocol and perfusion apparatus are discussed within.
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Cureus
November 2024
Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN.
The patient an 85-year-old female resided in a care facility where she maintained an independent daily activity level. She was discovered hunched over a table in her room, displaying reduced responsiveness and prompting an emergency call. Initially, her blood pressure was within 60 mmHg, and she was transported by ambulance to our hospital.
View Article and Find Full Text PDFAim: The optimal arterial partial pressure of carbon dioxide (PaCO) for patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) remains unknown. We aimed to investigate the association between post-resuscitation PaCO and neurological outcomes.
Methods: This retrospective cohort study analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan, a multicenter registry study across 36 hospitals in Japan, including patients with out-of-hospital cardiac arrest (OHCA) admitted to intensive care units (ICU) after ECPR between 2013 and 2018.
Cureus
November 2024
Department of Cardiovascular Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, JPN.
Trauma to the ascending aorta may progress to a cardiac tamponade, which is often life-threatening. Here, we report on a case of traumatic dissection of the ascending aorta, complicated by multiple injuries. A 24-hour follow-up period was provided to evaluate the traumatic bleeding, and a large tear that extended over three-quarters of the circumference of the aortic intima was identified.
View Article and Find Full Text PDFCirc Cardiovasc Qual Outcomes
December 2024
Surgical Sabermetrics Laboratory, Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Scotland (S.Y.).
Background: Safety in cardiac surgical procedures is predicated on effective team dynamics. This study associated operative team familiarity (ie, the extent of clinical collaboration among surgical team members) with procedural efficiency and Society of Thoracic Surgeons (STS) adjudicated patient outcomes.
Methods: Institutional STS adult cardiac surgery registry and electronic health record data from 2014 to 2021 were evaluated across 3 quaternary hospitals.
Comput Methods Programs Biomed
December 2024
Department of Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China; Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention of Shanghai, Shanghai, China. Electronic address:
Background And Objective: Cardiopulmonary exercise testing (CPET) serves as an integrative and comprehensive assessment tool for cardiorespiratory fitness. In this paper, we present a novel multi-dimensional multi-modal network (MDMNet) to identify functional limitation of organ systems via CPET, which is of great importance in clinical practice and yet a challenging task due to (1) the intricate intra-variable associations, and (2) the significant inter-individual variability.
Methods: The proposed model has three compelling characteristics.
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